Intermittent pneumatic compression therapy

Abstract

The use of intermittent pneumatic compression (IPC) devices in the therapeutic approach to lymphedema is perhaps the most controversial element of what is traditionally termed complex decongestive physiotherapy. In the United States, historically, pneumatic compression has been the mainstay of lymphatic therapy for decades. IPC, preferably accomplished with multi-chamber pumps, effectively removes excess fluid from the extremity. IPC can be incorporated into a multidisciplinary, therapeutic program; the guidelines for patient and device selection continue to evolve. Adjunctive IPC provides symptom relief and reduces episodes of cellulitis and ulceration in lower extremity lymphedema. Use of certain IPCs may be associated with significant reductions in cellulitis events, use of medical resources, and cost of care in lymphedema. The observed benefits of IPC correlate well with experimental physiological observations, in which the promotion of lymph formation by tissue compression is related to the number of compressions applied and the time interval between each compression. Compression of limb lymphedema tissues by IPC may lead to the formation of tissue channels that provide functional pathways for the clearance of edema fluid.